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Prognostic performance of an index based on lactic dehydrogenase and transaminases for patients with liver steatosis and COVID-19

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World Journal of Gastroenterology 2022年第37期28卷 5444-5456页

作者： Ricardo Ulises Macías-Rodríguez Alberto Adrián Solís-Ortega Victoria J Ornelas-Arroyo Astrid Ruiz-Margáin Maria Sarai González-Huezo Nestor A Urdiales-Morán Berenice M Román-Calleja Juan M Mayorquín-Aguilar JoséA González-Regueiro Alejandro Campos-Murguía Israel Vicente Toledo-Coronado Mónica Chapa-Ibargüengoitia Bernardo Valencia-Peña Carlos Fernando Martínez-Cabrera Nayelli C Flores-García Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Department of Gastroenterology Centro Médico ISSEMYMToluca 52140Mexico Department of Radiology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico

BACKGROUND Metabolic associated fatty liver disease(MAFLD)is associated with complications and mortality in patients with coronavirus disease 2019(COVID-19).However,there are no prognostic scores aimed to evaluate the risk of severe disease specifically in patients with MAFLD,despite its high prevalence.Lactate dehydrogenase,aspartate aminotransferase and alanine aminotransferase have been used as markers of liver damage.Therefore,we propose an index based on lactate dehydrogenase,aspartate aminotransferase and alanine aminotransferase for the prediction of complications and mortality in patients with MAFLD and COVID-19.AIM To evaluate the prognostic performance of an index based on lactate dehydrogenase and transaminases(aspartate aminotransferase/alanine aminotransferase)in patients with COVID-19 and MAFLD[liver fibrosis and nutrition(LNF)-COVID-19 index].METHODS In this retrospective cohort study,two cohorts from two different tertiary centers were included.The first was the derivation cohort to obtain the score cutoffs,and the second was the validation cohort.We included hospitalized patients with severe COVID-19 and MAFLD.Liver steatosis was evaluated by computed tomography scan.Area under the receiver operating characteristic(ROC)curve analysis and survival analysis were used.RESULTS In the derivation cohort,44.6%had MAFLD;ROC curve analysis yielded a LFN-COVID-19 index>1.67 as the best cutoff,with a sensitivity of 78%,specificity of 63%,negative predictive value of 91%and an area under the ROC curve of 0.77.In the multivariate analysis,the LFN-COVID-19 index>1.67 was independently associated with the development of acute kidney injury(odds ratio:1.8,95%confidence interval:1.3-2.5,P<0.001),orotracheal intubation(odds ratio:1.9,95%confidence interval:1.4-2.4,P<0.001),and death(odds ratio:2.86,95%confidence interval:1.6-4.5,P<0.001)in both cohorts.CONCLUSION LFN-COVID-19 index has a good performance to predict prognosis in patients with MAFLD and COVID-19,which could be useful for the MAFLD population.

关键词： COVID-19 Metabolic associated fatty liver disease Lactate dehydrogenase transaminases Prognosis Nonalcoholic fatty liver disease

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COVID-19 and liver diseases,what we know so far

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World Journal of Clinical Cases 2022年第13期10卷 3969-3980页

作者： Mohamed Elnaggar Ahmed Abomhya Ismail Elkhattib Nabila Dawoud Rajkumar Doshi Department of Internal Medicine University of Nevada Reno School of MedicineRenoNV 89052United States Department of Internal Medicine The Brooklyn Hospital CenterBrooklynNY 11200United States Department of Internal Medicine University of ConnecticutFarmingtonCT 06030United States Department of Internal Medicine University of KentuckyLexingtonKY 40508United States Department of Cardiology St Joseph's University Medical CenterPatersonNJ 07503United States

Coronavirus disease 2019(COVID-19)pneumonia outbreak started in December 2019.On March 12,2020,the World Health Organization(WHO)declared that the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)constitutes a pandemic,and as of May 2021,SARS-CoV-2 has infected over 167.3 million patients,including 3.4 million deaths,reported to WHO.In this review,we will focus on the relationship between SARS-CoV-2 infection and the liver.We will discuss how chronic liver diseases affect the COVID-19 disease course and outcomes.We will also discuss the SARS-CoV-2 effects on the liver,mechanisms of acute liver injury,and potential management plans.

关键词： COIVD-19 SARS-CoV-2 Liver diseases transaminases Non alcoholic fatty liver Hepatocellular carcinoma

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COVID-19-induced transaminitis and hyperbilirubinemia:Presentation and outcomes

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World Journal of Gastroenterology 2023年第7期29卷 1123-1130页

作者： Zeinab Nabil Ahmed Said Safinaz Adel El Habashy Samy Zaky ESCMID Study Group for Viral Hepatitis Department of Medical Microbiology and Immunology Faculty of Medicine(For Girls)Al-Azhar UniversityCairo 11754Nasr CityEgypt Department of Pediatrics Ain Shams UniversityCairo 11391AbbaseiaEgypt Department of Hepato-gastroenterology and Infectious Diseases Faculty of Medicine(For Girls)Al-Azhar UniversityCairo 11754Egypt 不详

The risk of liver injury in patients with coronavirus disease 2019(COVID-19)infection is quite evident.Furthermore,liver function test abnormalities are still detected in COVID-19 patients despite the development of antivirals and the availability of several types of vaccines.This editorial describes liver involvement during COVID-19 infection in patients with or without preexisting liver injury,such as chronic liver disease,to elucidate COVID-19-induced liver function abnormalities and their severity,pathophysiology,clinical manifestations,and clinical and laboratory outcomes.We also discuss the effect of vaccination against COVID-19 to better understand host factors,such as age,gender,and race,on the incidence and severity of liver dysfunction at initial presentation and during the illness.Finally,we summarize the results of relevant meta-analyses published to date and highlight the importance of adequate liver function monitoring in the current climate of the overwhelming COVID-19 pandemic.

关键词： COVID-19 SARS-CoV-2 Liver injury transaminases Hyperbilirubinemia Pathophysiology

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COVID-19 and the liver:Are footprints still there?

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World Journal of Gastroenterology 2023年第4期29卷 656-669页

作者： Tarana Gupta Hemant Sharma Department of Medicine Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical SciencesRohtak 124001HaryanaIndia

The coronavirus disease 2019(COVID-19)hit the entire world as a global pandemic and soon became the most important concern for all patients with chronic diseases.An early trend in higher mortality in patients with acute respiratory distress attracted all researchers to closely monitor patients for the involvement of other systems.It soon became apparent that patients with chronic liver diseases are at increased risk of mortality given their cirrhosis-associated immune dysfunction.Additionally,liver function abnormalities were noted in patients with severe COVID-19.Profound cytokine storm,direct viral infection,drugs and reactivation of viral infections were causes of deranged liver functions.Here,we discuss the relation between COVID-19 and chronic liver disease,specifically cirrhosis,hepatitis B,hepatitis C,and non-alcoholic fatty liver disease(NAFLD),as well as the liver manifestations of COVID-19.The metabolic syndrome,obesity,diabetes mellitus and NAFLD were found to worsen outcome in different studies reported worldwide.Decompensated cirrhosis should be considered a risk factor for death and severe COVID-19.Recently,COVID-19 related cholangiopathy has also been reported with changes of secondary sclerosing cholangitis.The long-term persistence of viral antigens in gut epithelia raises concern regarding the future risk of autoimmune liver diseases.

关键词： COVID-19 Chronic liver disease Cirrhosis Liver injury transaminases Non-alcoholic fatty liver disease Post-acute COVID-19 syndrome

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COVID-19 and liver disease: Are we missing something?

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World Journal of Hepatology 2022年第2期14卷 479-481页

作者： Tarana Gupta Department of Medicine Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical SciencesRohtak 124001HaryanaIndia

Since the coronavirus disease 2019(COVID-19)has hit the world as a pandemic,researchers all over the world have worked on its diagnostics,prognosticating factors,etc.The present study showed liver enzymes,especially aspartate aminotransferase(AST)levels,to be high in non-survivors with raised AST/alanine aminotransferase ratio.Considering the non-specific nature of AST with its presence in organs other than liver such as muscle,heart,kidney and brain makes it difficult to interpret.Even pre-existing metabolic syndrome and non-alcoholic fatty liver disease are confounding factors for deranged liver functions detected during COVID-19 disease.Therefore,the results of the study should be taken with caution.

关键词： COVID-19 Liver disease transaminases Non-alcoholic fatty liver disease Hepatocytes Cholangiocytes

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Changes of liver fat content and transaminases in obese children after 12-mo nutritional intervention

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World Journal of Hepatology 2013年第9期5卷 505-512页

作者： Elvira Verduci Carlo Pozzato Giuseppe Banderali Giovanni Radaelli Chiara Arrizza Antonio Rovere Enrica Riva Marcello Giovannini Department of Pediatrics San Paolo HospitalUniversity of Milan20142MilanItaly Unit of Medical Statistics San Paolo HospitalUniversity of Milan20142 MilanItaly Department of Radiology San Paolo Hospital20142 MilanItaly

AIM:To assess a relationship between longitudinal changes in liver fat content and biochemical parameters in obese children after 1-year nutritional intervention.METHODS:Forty-six obese children, 21 males and 25females, aged 6-14 years, underwent metabolic measurements, liver ultrasonography(US) and chemicalshift magnetic resonance imaging(MRI) examinations at baseline and after 1-year nutritional intervention. A child was defined obese if her/his body mass index(BMI)was above the age- and sex-adjusted BMI Cole's curve passing through the cut-off of 30 kg/m2 at 18 years.BMI Z scores were calculated and adjusted for age and gender by using the Cole's LMS-method and Italian reference data. Biochemistry included serum alanine aminotransferase(ALT) and aspartate aminotransferase(AST). Abdominal US and chemical-shift MRI were performed according to a randomized sequence.The same radiologist performed US by a GE Logiq 9(General Electric Healthcare Medical Systems, Milwaukee, WI, United States) using a 3.5-MHz convex array transducer. Liver echogenicity was evaluated independently on videotape by 3 radiologists unaware of the child and MRI outcomes, and a consensus was established. Another experienced radiologist, unaware of the child and US data, performed the abdominal chemicalshift MRI with a 1-t system NT-Intera(Philips Medical Systems, Best, The Netherlands) and a phased-array coil. Liver fat fraction(FF) on MRI was judged elevated when greater than 9%. A FF>18% was considered expressing more severe cases of fatty liver according to Fishbein. A nutritional-behavioral intervention was recommended to promote a normocaloric balanced diet and active lifestyle based on the Italian guidelines for treatment of childhood obesity.RESULTS:Compared to baseline, at the end of intervention children showed lower intakes of energy(mean± SD:2549±1238 Kcal vs 1770±622 Kcal, P<0.0001), total fat(90±47 g vs 52± 23g, P<0.0001),carbohydrates(356±174g vs 241±111 g, P=0.001),and protein(99±48g vs 75±23g, P=0.006) intakes. Prevalence of F

关键词： Nonalcoholic fatty liver disease Childhood obesity Serum transaminases Magnetic resonance imaging Nutritional intervention

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Combined non-alcoholic fatty liver disease and type 2 diabetes in severely obese patients-medium term effects of sleeve gastrectomy versus Roux-en-Y-gastric bypass on disease markers

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Hepatobiliary Surgery and Nutrition 2022年第6期11卷 795-807页

作者： Franck Billmann Sherehan El Shishtawi Tom Bruckner Mostafa ElSheikh Beat Peter Muller-Stich Adrian Billeter Department of Surgery University Hospital of HeidelbergHeidelbergGermany Institut für Medizinische Biometrie und Informatik Universität HeidelbergHeidelbergGermany Department of General Surgery El-Gharbia GovenorateTantaEl gash St.Medical CampusThe Faculty of MedicineTantaEgypt

Background:We aimed to evaluate the medium-term efficacy of sleeve gastrectomy(SG)vs.Roux-en-Y gastric bypass(RYGB)on remission of non-alcoholic fatty liver disease(NAFLD)in patients with type 2 diabetes mellitus(T2DM).Methods:We identified severely obese patients[body mass index(BMI)>35 kg/m^(2)]with NAFLD(as defined by the Longitudinal Assessment of Bariatric Surgery Study)and T2DM(as defined by the American Association of Clinical Endocrinologists and the American College of Endocrinology)who underwent SG or RYGB in a single university surgical centre.The cohorts were match-paired and data were analysed after at least 3 years of follow up.The key outcomes measured were:(I)the improvement of liver function tests and NAFLD markers;(II)glycemic control and insulin resistance.Results:Ninety-six patients were investigated;44(45.8%)were women.The mean pre-operative BMI was 45.2 kg/m2 in the SG and 42.0 kg/m^(2) in the RYGB group.SG and RYGB both significantly reduced serum liver enzyme concentrations.NAFLD markers resolved 2 years after SG in all patients.In contrast,only 78%and 80%of patients achieved remission of NAFLD 2 and 3 years after RYBG respectively.Both procedures resulted in comparable rates of remission of T2DM.Conclusions:Bariatric surgery with SG may be preferable to RYGB for obese patients with NAFLD and T2DM based on the rates of remission of markers of these co-morbidities.However,our results need to be confirmed in prospective trials.Understanding the metabolic effects of specific bariatric surgical procedures may facilitate the development of a personalised approach to weight-loss surgery.

关键词： Bariatric surgery morbid obesity complications non-alcoholic fatty liver disease(NAFLD) type 2 diabetes mellitus(T2DM) gastric bypass sleeve gastrectomy(SG) transaminases

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Investigation of minerals, testosterone, and transaminases in the semen and serum of fertile and infertile men belongs to different age groups

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Advances in Bioscience and Biotechnology 2012年第5期3卷 574-579页

作者： Zahed Mahmood Muhammad Riaz Imtiaz Mahmood Tahir Abdul Shakoor Zia-ur Rahman Muhammad Usman Qamar Saeed Department of Chemistry and Biochemistry University of Agriculture Faisalabad Pakistan Department of Physiology and Pharmacology University of Agriculture Faisalabad Pakistan

The present study was aimed to assess the potential of infertility to induce the adverse effects with reference to testosterone, Triiodothyronine (T3), Thyroxine (T4), Alanine Aminotransferase (ALT), Aspartate Amino-transferase (AST), zinc, copper and iron. All the samples were divided into four groups according to age and disorder (Group 1, 10 infertile men of 25-40 years;Group 2, 10 fertile men of 25-40 years;Group 3, 10 infertile men of 41- 60 years and Group 4, 10 fertile men of 41-60 years). Semen and blood samples were analyzed by atomic absorption spectrophotometry to determine minerals while, Testosterone, T3 and T4 were determined by enzyme immunoassay kits. ALT and AST were determined using standard kit assay method. The levels of testosterone and T3 and AST in the fertile semen of 41-60 years age group were increased significantly (P ≤ 0.001) as compared to that of fertile semen of 25-40 years age group. While, the level of T4 in the fertile semen of 41-60 years age group was decreased significantly (P ≤ 0.001) as compared to that of fertile semen of 25-40 years age group. In case of fertile serum, only the level of testosterone was significantly decreased (P ≤ 0.05) in the 41-60 years age group as compared to 25-40 years age group. The levels of testosterone and Cu in the infertile serum of 41-60 years age group were decreased significantly (P ≤ 0.001). While, the levels of T3, T4, ALT and Fe in the infertile serum of 41-60 years age group were increased significantly (P ≤ 0.05) as compared to that of infertile serum of 25-40 years age group.

关键词： Semen Reproduction Infertility Minerals Testosterone transaminases

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Role of sodium-glucose co-transporter-2 inhibitors in the management of nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2019年第28期25卷 3664-3668页

作者： Anastasia Kontana Konstantinos Tziomalos First Propedeutic Department of Internal Medicine Medical School Aristotle University of Thessaloniki AHEPA Hospital

Nonalcoholic fatty liver disease (NAFLD) is the most prevalent cause of chronic liver disease worldwide. NAFLD is considerably more frequent in patients with type 2 diabetes mellitus (T2DM) than in the general population and is also more severe histologically in this group. Sodium-glucose co-transporter-2 (SGLT2) inhibitors, the newest class of antidiabetic agents, appear to represent a promising option for the management of NAFLD in patients with T2DM. In a number of studies, treatment with SGLT2 inhibitors resulted in a reduction in hepatic steatosis and in transaminase levels. However, existing studies are small, their follow-up period was short and none evaluated the effects of SGLT2 inhibitors on liver histology. Accordingly, larger studies are needed to verify these preliminary results and define the role of SGLT2 inhibitors in the treatment of NAFLD in patients with T2DM.

关键词： Nonalcoholic fatty liver disease Type 2 diabetes mellitus Sodium-glucose co-transporter-2 inhibitors Steatosis Fibrosis transaminases

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Morphological and biochemical effects of weekend alcohol consumption in rats: Role of concentration and gender

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World Journal of Hepatology 2018年第2期10卷 297-307页

作者： José A Morales-González María de Lourdes Sernas-Morales ángel Morales-González Laura Ligía González-López Eduardo Osiris Madrigal-Santillán Nancy Vargas-Mendoza Tomás Alejandro Fregoso-Aguilar Liliana Anguiano-Robledo Eduardo Madrigal-Bujaidar Isela álvarez-González Germán Chamorro-Cevallos Laboratorio de Medicina de Conservación Escuela Superior de Medicina Instituto Politécnico Nacional Escuela Superior de Cómputo Instituto Politécnico Nacional área Académica de Nutrición ICSa Universidad Autónoma del Estado de Hidalgo Depto. de Fisiología Laboratorio de Hormonas y Conducta ENCB campus Zacatenco Instituto Politécnico Nacional Laboratorio de Farmacología Molecular Sección de Estudios de Posgrado e Investigación Escuela Superior de Medicina-Instituto Politécnico Nacional Laboratorio de Genética Escuela Nacional de Ciencias Biológicas IPN Departamento de Farmacia Escuela Nacional de Ciencias Biológicas Instituto Politécnico Nacional

AIM To examine the association between weekend alcohol consumption and the biochemical and histological alterations at two different concentrations of alcohol in both genders in rats.METHODS Wistar rats weighing 170-200 g were divided into groups as follows:(1) Control groups; and(2) weekend alcohol-consumption group: 2 d/weekly per 12 wk, at two different concentrations:(1) Group of males or females with a consumption of a solution of alcohol at 40%; and(2) group of males or females with a consumption of a solution of alcohol at 5%. At the end of the experiment, serum and liver samples were obtained. The following enzymes and metabolites were determined in serum: Alanine Aminotransferase(ALT), Aspartate Aminotransferase(AST), Lactate Dehydrogenase, and Gamma-Glutamyltransferase, and glucose, triglycerides, cholesterol, bilirubin, and albumin. Liver samples from each group were employed to analyze morphological abnormalities by light microscopy.RESULTS In all of the weekend alcohol-consumption groups, AST activity presented a significant, 10-fold rise. Regarding ALT activity, the groups with weekend alcohol consumption presented a significant increase that was six times greater. Bilirubin levels increased significantly in both groups of females. We observed a significant increase in the parameters of fatty change and inflammation due to weekend alcohol consumption. Only the group of females that consumed alcohol at 40% presented slight hepatocel ular disorganization CONCLUSION The results obtained herein provide solid evidence that weekend alcohol consumption gives rise to liver damage, demonstrated by biochemical and histological alterations, first manifested acutely, and prolonged weekend alcohol consumption can cause greater, irreversible damage.

关键词： Weekend alcohol consumption Liver morphology transaminases Damage

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